or la grippe, phenacetin is of exceptional value in the treatment of the sequelæ of that complicated condition; and this would point to a probable power of phenacetin to modify nerve function. The powerful analgesic properties of phenacetin would point still more directly to this conclusion, while the perfect safety with which the remedy may be given would seem to be referable to the ease with which it is finally handled by the emunctories.

But, however we may explain the varied action of these remedies at different times under different pathological conditions, it seems desirable, as we have hinted, to keep in view the fact that the aromatics should not be classed together (therapeutically) as a series, but should be clinically estimated in accordance with the work they have accomplished.

Treatment of Puerperal Peritonitis.

Dr. A. L. Smith (Amer. Jour. of Obstet., January, 1892) says: The temperature should be taken every day after every confinement, and on the slightest rise, vaginal douches of permanganate solution should be commenced.

If the temperature continues to rise, the douches should be made intra-uterine.

If there is no improvement at the end of twenty-four hours, scrape out the uterus with the finger or with the curette, applying strong tincture of iodine, wash out the uterus, and drain with iodoform gauze.

If the case proceeds from bad to worse, and peritonitis sets in, perform an exploratory incision, and, if no other evident cause can be found, remove the uterus.

Quinine pills and capsules are very insoluble, often being discharged undissolved. Febriline, or Tasteless Syrup of Quinine, has been found to be just as reliable in all cases as the bitter sulphate of quinine, and physicians will find it to their advantage to use it for adults, as well as children, in place of pills and capsules. It is as pleasant as lemon syrup and will be retained by the most delicate stomach, having also the advantage of not producing the unpleasant head symptoms of which so many patients complain after taking the quinine sulphate. Possessing these advantages, physicians will find it superior to the quinine sulphate for all cases requiring quinine, particularly typhoid fever patients.

KS

Memphis Medical Monthly

[FORMERLY MISSISSIPPI VALLEY MEDICAL MONTHLY.]

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Memphis, Tennessee.

FORENSIC PSYCHIATRY.

Alice Mitchell Adjudged Insane.

On the eighteenth day of last month Alice Mitchell was taken before the Shelby County Criminal Court in the hope of determining the status of her mind, with the view of confining her in an insane asylum if insane, or trying her for murder if sane. The court was presided over by Judge J. J. DuBose. The State was represented by Attorney-General Geo. B. Peters, who was assisted by Messrs. F. L. Bates, William Fitzgerald, Castleberry, G. S. Landis and Harris, all young practitioners at the bar; while the defense was handled by Col. George Gant, Gen. Luke E. Wright, and Mr. M. H. Patterson. By the Judge and the attorneys on either side the very best legal talent of the country was represented. The jurors were selected from among the best citizens of Memphis.

So much interest has been manifested in this very remarkable case, that we deem it our duty toward the profession to place the facts on record.

The first question that presents itself to the alienist is: If insane, from whence come the etiological factors? Heredity, that most common and potent of all causes of mental disturbances, was proven beyond a doubt: Some of the ancestry of the mother were shown to have been insane. The parents of Mrs. Mitchell died when she was an infant. One of her brothers was insane for a considerable period, one of her uncles was insane, and several of her first cousins were insane. The mother of Alice had puerperal insanity, as testified to by Dr.

Thomas G. Comstock of St. Louis, Mo., following the birth of her first child in 1857. Dr. Comstock attended her for one month, then advised her removal to an insane asylum. After an asylum treatment of two months she returned to her home, apparently well. In a few days her mind became again unbalanced by the news of the death of her child. This mental aberration, however, continued only a few days, but she remained melancholy, suffering from hallucinations, and entertained the most groundless prejudices and fears. The prosecution claimed that the insanity of the ancestry of the mother was purely accidental and due to recognized causes, other than the insane temperament. The defense urged that such factors were recognizable wholly as exciting causes. True brain disease resulting in mental alienation may follow a variety of factors unassociated with heredity, but when more than one person in a generation or two become insane from "exciting causes," we are forced to recognize the great probability of an underlying neuropathy. Doubt may be entertained as to whether puerperal mania indicates an insane temperament, but it must be removed when the character of the case had by the mother is fully analyzed, for the insane tendency itself becomes appar ent. Among the evidences of disturbed mentality was a groundless and absurd antipathy to a devoted sister that she fondly loved, and a like groundless aversion against a highly-cherished female friend. About the same time she was possessed with the unfounded belief that a stepdaughter, twelve years of age, who was much attached to her children, intended to kill them, and would not allow her to sleep in the same room with them. She formed the purpose of putting this stepchild to death, without any cause whatever. She could not be reasoned out of her belief that the stepchild intended to kill her children, or her purpose to take the life of her stepchild. Efforts to do so only inflamed and excited her, and her husband was compelled to send the stepchild to live with his relatives. The melancholia, the grave forebodings, the suspicions, apprehensions, etc., after her recovery, taken with the fact that she was under treatment requiring more or less restraint for three months, leaves no room for doubt that the mother had inherited a neuropathology of insane proneness. These family

taints are difficult to determine, as persons hesitate to believe that they exist, much less mention them. In hospital practice D. Hack Tuke says that 47 per cent. of puerperal insanities have the history of the insane temperament.

Alice was the seventh child, and her mother evinced more or less mental disturbance with each parturition, especially after the birth of Alice. The following facts were fully proven in court:

HYPOTHETICAL CASE.

Alice was a nervous, excitable child, and somewhat under size. As she grew she did not manifest interest in those childish amusements and toys that girls are fond of.

When only four or five years old she spent much time at a swing in the yard of the family in performing such feats upon it as skinning the cat, and hanging by an arm or leg. She was fond of climbing, and was expert at it.

She delighted in marbles and tops, in base ball and foot ball, and was a member of a children's base ball nine. She spent much time with her brother Frank, who was next youngest, playing marbles and spinning tops. She preferred him and his sports to her sisters. He practiced with her at target shooting with a small rifle, to her great delight. She excelled this brother at tops, marbles, and feats of activity.

She was fond of horses, and from early childhood would go among the mules of her father and be around them when being fed. About six or seven years ago her father purchased a horse. She found great satisfaction in feeding and currying him. She often rode him about the lot bareback, as a boy would. She was expert in harnessing him to the buggy, in looking after the harness, and mending it when anything was amiss. To the family she seemed a regular tomboy.

She was willful and whimsical. She disliked sewing and needlework. Her mother could not get her to do such work. She undertook to teach her crocheting, but could not. She was unequal in the manifestation of her affections. To most persons, even her relatives, she seemed distant and indifferent. She was wholly without that fondness for boys that girls usually manifest.

She had no intimates or child sweethearts among the boys,